慢性意識障礙命名與分類專家共識

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【中圖分類號】 R651 【文獻標志碼】 A 【文章編號】 1672-7770（2025）03-0241-07

Abstract：Disorders of consciousness（DoC） refers to the state of impaired consciousness caused by severe traumatic brain injury. Over the past three decades，driven by advancements in functional imaging and neuroelectrophysiological technologies，significant progress has been made in consciousness science，making the research of consciousness and DoC hot topics in clinical neuroscience. To enhance clinicians’ awareness and precise understanding of DoC and provide guidance for standardized assessment and management，a hierarchical and progressive DoC classification system based on evidence-based definitions，diagnostic criteria，and assessment methods has been developed. This system integrates recommendation grading systems referring to U.S.，European，and U.K. practice guidelines for DoC patients’ management and international guideline standardization frameworks. The system deconstructs prolonged DoC（pDoC） into two core dimensions：arousal and awareness，resulting in seven recommendation statements. These statments clarify clinical entities such as vegetative state/unresponsive wakefulness syndrome（VS/UWS）， minimally conscious state（MCS） and its subtypes（ MCS+ and MCS -），and emergence from MCS （EMCS）. Notably，it introduces cognitivemotor dissociation（CMD）as a diagnostic concept for states of covert consciousness. Furthermore， the consensus refines pediatric DoC assessment criteria，emphasizing the impact of developmental characteristics on diagnosis. It also proposes explicitly to distinguish locked-in syndrome（LIS） from the DoC spectrum.This framework aims to standardize DoC diagnosis and provide actionable clinical guidance.

Key words ：consciousness； disorders of consciousness ；diagnostic standard;coma;vegetativestate/unresponsive wakefulness syndrome； minimally conscious state； locked-in syndrome;expert consensus

意識障礙（disordersofconsciousness，DoC）是指因嚴重腦損傷導致的意識喪失狀態(tài)。（剩余17309字）